notes

1. INTRODUCTION
Gone are the days when counselling is just for the mentally ill. It has been used by
different people since the mankind by teachers, parents, friends and elders etc. People
typically enter counselling they are hurted, frustrated or feeling overwhelmed by a problem.
seek out a professional when your mind seems broken or sprained with marital and as well
as health related problems. Present days counselling is moving towards teaching the client
life coping skills both interpersonal and involving the clients family in the process of
counselling.
DEFINITION OF PREMARITAL COUNSELLING
Premarital counselling is a therapeutic couple intervention that occurs with couples
who plan to marry (murray and murray 2004)
Premarital counselling is a skill training procedure which aims at providing
information on ways to improve their relationship once they are married (senediak 1990).
NEED FOR PREMARITAL COUNSELLING
 When a person is young and have never been married require by law that the
individuals under the age of 18 complete premarital counselling before the wedding.
 When one partner is commitment-phobia.
 When a couple cannot resolve significant issues
 When one or both partners have a previously failed marriage and want to avoid
repeating the same mistakes.
 Difficulty handling conflicts
 To educating engaged couples and newlyweds in the skills, habbit, attitudes and
enrichment techniques that research shows lead to happy, enduring marriages.
FUNCTIONS OF PREMARITAL COUNSELLING
Mainly it divide into 2 functions
1) To assist couples in developing skills to navigate their way through marriage
successfully.
2) To identify areas of difference between couples that may become a source of conflict
later.
PREMARITAL ADDRESSES THE FOLLOWING AREAS
 Interests and activities
 Role expectations

2.  Personal adjustments
 Interpersonal communication
 Religion and philosophy
 Marriage expectations
 Family issues
 Finances
 Parenting
 Sexuality
PREMARITAL COUNSELLING EXPECTATIONS
 Compatibility
 Personalities and families of origin
 Communication
 Conflict resolution
 Intimacy and sexuality
 Goal achievements.
GENITIC COUNSELLING
DEFINITION
Genetic counselling is defined as the process of communication and education that
addresses concerns relating to the development and or transmission of hereditary disorders.
AIMS AND OBJECTIVES
 To help the individual and family to understand the medical facts about the diagnosis
course and treatment.
 To reduce the number of children of children affected with the hereditary condition
by prenatal detection of a disorder.
 To reassure people who are concerned about their children inheriting a particular
disorder that their fears are groundless.
 To allow the people who are affected by inherited disorders to make informed
choices about future reproduction.
 To educate people about inherited disorder and the process of inheritance

3.  To offer support by skilled health care professionals to people who are affected by
genetic illness.
PURPOSES OF GENETIC COUNSELING
a) To reduce the incidence of the genetic disease in the general population
b) To provide information related to medical and genetic facts
c) The genetic counselling process can facilities informed decision making and offer
support to patients and their families.
TYPES OF GENETIC COUNSELLING
 Prospective genetic counselling
Usually pre marital, especially when the couples are related. This approach is mainly for
heterozygous individuals for any particular defect by screening procedures and explaining to
them the risk of their having affected children if they marry another heterozygote for the
same gene.
 Retrospective genetic counselling
There is a way a history of either an offspring or other relative being affected. This
counselling is mostly using and this is a hereditary disorder has already occurred with in the
family.
 Expanded family genetic counselling
Usually given in chromosomal abreactions occurring secondary to balanced translocation or
inversions and in x linked conditions.
STEPS IN GENETIC COUNSELLING
1. DIANNOSIS
2. PROGNOSIS
3. TREATMENT
4. INHERITANCE AND RECURRENCE RISKS
5. GENETIC TESTING
GENETIC COUNSELLING TEAM
It requires team work. The team members includes, the nurse, the
family, the geneticist, and other concerned members of the helping profession.

4. BENEFICIARIES OF GENETIC COUNSELING
A couple who has a child with a congenital abnormality or inborn errors of
metabolism, any developmental delay or mental retardation.
A couple whose close relatives have a child with genetic disorder, including those
with a child who has a congenital abnormality.
Individual who has an inborn errors of metabolism or chromosomal disorder or
congenital abnormality.
Any women over 35 years of age and any man over 45 years of age.
Women who have had three or more miscarriage or infertility from an unknown
cause.
Prenatal diagnosis of any genetic disorders.
People who have inherited tendency to develop cancer or neurological condition
such as Huntington’s disease
LEGAL ASPECTS OF GENETIC COUNSELLING
1. Informed consent
2. Must be elective, not mandatory
3. Results should be interpreted carefully
4. Results must not be with held from individuals
5. Be confidential
MARIETAL COUNSELLING
It is the process by which a professionally trained counsellor assist a person or
persons to resolve the problems that trouble in their interpersonal relationship as they move
into marriage, live within it or make a decision to terminate it ( godwin and mudd).
PURPOSE OF MARIETAL COUNSELLING
1 Usually concerned with individuals who are trouble and who frequently have severe
psychological difficulties in their live.
2 marriage counselling diagnose and treats an interpersonal relationship rather than treating
an Individual
3 to provide healthy and happiness in marriage life.

5. SESSIONS
a) Individual or joint marriage counselling sessions which usually are from 45 mts to
an hour in length
b) Each spouse is encourage to ventilate his or her feelings and attitude towards himself
and his mate.
MARRIAGE COUNSELLOR
According to American association of Marriage Counsellor should have a
knowledge of human growth and development and of dynamics of hu,man behaviour and
human motivation, capacity to differentiate between normal and abnormal behaviour
mechanisms and relationships within the family group.
Counsellor are found in clinics, hospitals, health centres, and government or
educational agencies. A licensed marriage counsellor is imperative.
Functions of marriage counsellor.
o Informer
o Assisting in client in decision making
o Reorganisation of behaviour
BENEFITS OF MARRIAGE COUNSELLING
1. couples are made to understand what these differences are and how they can re-directed
so that they serve the marriage, not destroy it.
2. to handle a bad day and stress levels.
3. to avoid of psychological problems later.
4. marriage counselling is beneficial to couples who are having opposing views such as
Sexual problems
Communication problem
Angry to small things
Cultural gap
Infidelity
Physical or mental handicaps
Health problems
Changing situation eg: retirement

6. 5 help to prevent escalation of physical or verbal abuse.
NURSE;S RESPONSIBILITY
1 ASSESSMENT
It include
History collection
Physical examination
2 DIAGNOSTIC TESTING
a) identify accurate genetic screening
b) provide important clues about possible disorders
3 CALCULATING AND PRESENTING THE RISK
provide information that enables client to take accurate decision
4 DISCUSSING THE OPTIONS
Diagnosis and discussed the risk of occurrence or recurrence.
5 COMMUNICATION AND SUPPORT
It should be a two way process, educate patient and family members about
counselling.
CONCLUSION
Counselling has reached the lime light of public attention. It is crucial that the
reverent regulation be designed. The way the problem are dealt with its always changing
just as society is in constant process of change. It is important, however, that we always be
resdy to offer proper help to those in need when they need it.
BIBILOGRAPHY
1 Stuart.G, principles and practice of psychiatric nursing, 9th edition c.v mosby publishers pg:
420-421
2 Bower MA Ethical and professional challenges in practice, journal of genetic counselling
2002, pg;163-186.